V. Fesslova' et al., Evolution and long term outcome in cases with fetal diagnosis of congenital heart disease: Italian multicentre study, HEART, 82(5), 1999, pp. 594-599
Citations number
39
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Objectives-To analyse the evolution and outcome in utero and after birth of
infants with a fetal diagnosis of congenital heart disease.
Design-Inclusion criteria were the fetal diagnosis of congenital heart dise
ase, confirmed postnatally or postmortem, and a complete follow up in utero
and after birth.
Setting-20 centres operating prenatal echocardiographic screening.
Patients-847 cases were included in the study. Gestational age at diagnosis
ranged from 15-39 weeks; in 370 cases (43.7%) the diagnosis was made befor
e 24 weeks' gestation.
Results-245/847 cases (28.9%) were terminated during pregnancy, 227 followi
ng early diagnosis; 128/245 cases (52.2%) had associated anomalies and 117/
245 (47.8%) had serious congenital heart disease. Of the remaining 602 case
s that continued the pregnancy, 72 (11.9%) died in utero, 259 (43%) died po
stnatally (83 after surgery or invasive procedures), and 271 infants (45%)
survived and presently range in age from 18 months to 13 years old. The mor
tality rate was higher in cases with associated extracardiac or chromosomal
anomalies (68% and 74% of cases continuing pregnancy, respectively), and i
n cases with heart failure and complex cardiac defects.
Conclusions-The data confirm a relevant fetal and postnatal loss in cases w
ith complex congenital heart disease, and major clinical use of prenatal di
agnosis in the management of ductus dependent anomalies. Negative prognosti
c factors for the outcome were associated anomalies and heart failure.